Attendants Not Entitled to Compensation for Driving People with Disabilities to Medical Appointments

The 10th Circuit Court of Appeals upholds a federal district court’s decision to dismiss a case brought by a Colorado woman with disabilities who alleged discrimination after the state refused to compensate her personal care attendant for their time driving her to medical appointments. Taylor v. Colorado Department of Health Care Policy and Financing (10th Cir., No. 14-1161, Jan. 26, 2016).

Leslie Taylor receives Medicaid services because of a disability that confines her to a wheelchair and prevents her from driving. Ms. Taylor works with two personal care attendants, who are paid through the Colorado Consumer Directed Attendant Support Services (CDASS) program but are not paid for driving beneficiaries to medical appointments. A second state program, the Non-Emergency Medical Transportation (NEMT) program, reimburses drivers in rural counties up to $0.39 per mile for transporting Medicaid recipients to medical appointments. Ms. Taylor asked the state to combine the two programs in order to compensate her not just for her mileage but pay her attendants for their time driving her to medical appointments. When the state refused, Ms. Taylor filed suit against the state in federal court, alleging discrimination based on her disability. Her claims were dismissed.

On appeal, Ms. Taylor claimed that the state was required to fully compensate her for personal care attendant services, that its failure to modify the transportation program to fit her needs was discriminatory and that the agency treated her differently than other similarly situated Medicaid recipients who did receive transportation payments.

The 10th Circuit Court of Appeals upholds the district court’s ruling. The court states that “[n]either the Americans with Disabilities Act nor the Rehabilitation Act requires Medicaid programs to compensate the disabled for all of their transportation costs. Though the per-mile reimbursement was inadequate for Ms. Taylor, that inadequacy does not make the reimbursement discriminatory.” In addition, the court finds that “‘an accommodation only is required when necessary to avoid discrimination on the basis of a disability.’ Under this standard, Ms. Taylor cannot prevail because the requested accommodation (payment of her attendants to drive to medical appointments) was not available to anyone, disabled or not. Thus, Colorado was not obligated to alter its Medicaid programs by creating a new benefit previously unavailable to any Medicaid recipients.”